Laparoscopic gastrostomy: towards the ideal technique.

Background: Laparoscopic gastrostomy is the best option for long-term gastric intubation when percutaneous endoscopic gastrostomy is not possible. The ideal technique is yet to be defined.

Methods: A technique of suturing the gastric wall to the posterior rectus sheath under direct vision has been developed.

Angiogenesis is associated with vascular endothelial growth factor expression in cervical intraepithelial neoplasia.

Squamous cell carcinoma of the cervix (SCC) is preceded by a premalignant condition known as cervical intraepithelial neoplasia (CIN). The majority of cases of CIN regress spontaneously; however, methods are needed to identify those lesions likely to progress. Increased blood vessel density, signifying angiogenesis, is an independent prognostic indicator in a number of cancers, although little is known about its significance in premalignant lesions.

Isolation and culture of human gastric endothelial cells.

Background & Aims: Angiogenesis plays an important role in gastric ulcer healing. Considerable heterogeneity exists between endothelial cells from different blood vessels in vitro. Hitherto, it has not been possible to study gastric angiogenesis using relevant endothelial cells.

The movement of mucosal cells of the gallbladder within the peritoneal cavity during laparoscopic cholecystectomy.

Background: Tumor dissemination to trocar sites following the removal of a gallbladder malignancy by laparoscopic cholecystectomy is well documented. The mode of transfer of malignant cells to those sites remains unclear.

Methods: The appearance and movement of gallbladder mucosal cells within the peritoneal cavity during laparoscopic cholecystectomy was prospectively studied in 15 patients.

Intraperitoneal cell movement during abdominal carbon dioxide insufflation and laparoscopy. An in vivo model.

Purpose: Possible mechanisms of movement of malignant cells within the peritoneal cavity during CO2 insufflation and laparoscopy involve direct transfer via laparoscopic instruments or dispersion of cells by CO2 or water vapor. An in vivo model has been developed to study these mechanisms.

Methods: Laparoscopy was performed on an animal model (domestic white pig).

Modulation of human endothelial cell procoagulant activity in tumour models in vitro.

Several tumour-derived factors have recently been identified which induce tissue factor (TF) expression in endothelial cells in vitro. However, there is only limited evidence that endothelial cells lining tumour blood vessels express elevated procoagulant activity (PCA) in vivo. We have investigated the effects of human breast and small cell lung cancer cell lines on the PCA of human micro- and macrovessel endothelial cell monolayers using a one-stage clotting assay, as well as detection of TF mRNA by RT-PCR.

Laparoscopic anterior resection: a consecutive series of 84 patients.

Laparoscopic colorectal surgery is in its infancy. From a series of over 200 colorectal procedures undertaken over the last 30 months, we have performed 84 anterior resections. In 55 women and 29 men, median age 64 years (range 32-86), median weight 72 kg (range 36-125), surgery was undertaken for benign pathology (n = 57) and adenocarcinoma (n = 27).

Hereditary presacral teratoma.

A case of hereditary presacral teratoma involving father and daughter is described. The use of magnetic resonance imaging in the diagnosis of this condition is illustrated and a review of the literature of this unusual condition is presented.

Coexpression of flt-1, flt-4 and KDR in freshly isolated and cultured human endothelial cells.

Vascular endothelial cell growth factors (VEGF) are key modulators of endothelial cell growth and function. The class III receptor tyrosine kinases KDR and Flt-1 are high affinity receptors for VEGF, while Flt-4 is a receptor for the recently identified VEGF-C. We have examined the expression of flt-1, flt-4 and KDR in human microvascular and large vessel endothelial cells and in a variety of other cell types in vitro.

A novel method of rectal occlusion during anterior resection of the rectum.

An inexpensive and effective method of rectal occlusion during low anterior resection using a commercially available cable tie is described. Its use facilitates cross stapling of the rectum distal to the tumour.

A proposed model for the movement of cells within the abdominal cavity during CO2 insufflation and laparoscopy.

Background: The application of laparoscopic-assisted surgery to gastrointestinal malignancy has lead to the recurrence of malignancy in wounds created during these procedures by laparoscopic ports.

Methods: Possible mechanisms of this complication have been studied in an in vitro model. Using filter systems, we have examined the expelled carbon dioxide used during laparoscopy and the laparoscopic ports and instruments for the presence of malignant cells.

A review of intestinal injury from blunt abdominal trauma.

Eighty-five patients who suffered blunt trauma to the small intestine and/or to the colon were treated at either the Royal Brisbane Hospital (RBH), Brisbane, Queensland or the Flinders Medical Centre (FMC), Adelaide, South Australia, between 1980 and 1991. Data were collected by retrospective review of case notes from the medical records departments of both hospitals and analysed with respect to the cause, the anatomical distribution, the diagnostic methods and the mortality of these injuries. There were 129 intestinal injuries (44 colonic and 85 small bowel).

Harry E. Bacon Oration. Comparison of the functional results of restorative proctocolectomy for ulcerative colitis between the J and W configuration ileal pouches with sutured ileoanal anastomosis.

Purpose: This study was designed to compare function of patients who had undergone reconstruction following proctocolectomy for ulcerative colitis using the J or W configuration ileoanal pouch.

Methods: Of 126 patients who underwent restorative proctocolectomy between January 1981 and March 1993, 101 had surgery for ulcerative colitis. Eighty-seven of these patients were available for review by personal or postal interview.

The treatment of internal fistulae that complicate diverticular disease of the sigmoid colon by laparoscopically assisted colectomy.

Seven patients with internal fistulae complicating colonic diverticular disease were treated by laparoscopic assisted colectomy over a 24-month period. Prospective review of these patients was carried out to ascertain efficacy of the treatment. No intraoperative complications were encountered and return of gastrointestinal function was apparent within two days in all cases.

Variability of particle size-specific fractions of personal coal mine dust exposures.

This study estimated the ratio of the tracheo-bronchial dust fraction to the fraction collected by a respirable dust sampler for a variety of job classifications found in conventional, continuous, and longwall coal mining sections. The ratios could then be applied in epidemiologic studies to existing respirable dust measurements to estimate thoracic mass concentrations for evaluation of the relative importance of the respirable and thoracic dust fractions to obstructive lung disease. Data collected include particle size distributions from four U.

Ureteric ischaemia following major colorectal resection.

An ischaemic injury of the ureter following major colorectal surgery is reported. The aetiology and incidence of this unusual complication is reviewed. Surgical techniques for prevention of such an injury are discussed.

Estimation of regional pulmonary deposition and exposure for fumes from SMAW and GMAW mild and stainless steel consumables.

The particle size distributions and bulk fume densities for mild steel and stainless steel welding fumes generated using two welding processes (shielded metal arc welding [SMAW] and gas metal arc welding [GMAW]) were used in mathematical models to estimate regional pulmonary deposition (the fraction of each fume expected to deposit in each region of the pulmonary system) and regional pulmonary exposure (the fraction of each fume expected to penetrate to each pulmonary region and would be collected by a particle size-selective sampling device). Total lung deposition for GMAW fumes was estimated at 60% greater than that of SMAW fumes. Considering both the potential for deposition and the fume specific surface areas, it is likely that for equal exposure concentrations GMAW fumes deliver nearly three times the particle surface area to the lungs as SMAW fumes.

The particle size distribution, density, and specific surface area of welding fumes from SMAW and GMAW mild and stainless steel consumables.

Particle size distributions were measured for fumes from mild steel (MS) and stainless steel (SS); shielded metal arc welding (SMAW) and gas metal arc welding (GMAW) consumables. Up to six samples of each type of fume were collected in a test chamber using a micro-orifice uniform deposit (cascade) impactor. Bulk samples were collected for bulk fume density and specific surface area analysis.

The influence of age of template DNA derived from archival tissue on the outcome of the polymerase chain reaction.

The analysis of DNA from archival tumour tissue for molecular alterations has been facilitated by the use of the polymerase chain reaction (PCR). Degradation of tissue prior to fixation and the nature of the fixative used influence successful amplification from archival tissue. Age of the archival tissue may also be a factor.

A comparison of Southern blot and polymerase chain reaction as techniques to identify loss of DNA heterozygosity in colorectal cancer.

Alterations in the tumour suppressor gene p53 have been found in a wide variety of tumours. The variable number tandem repeat present at the YNZ22 locus is a highly polymorphic marker closely linked to the p53 gene. Examination for loss of heterozygosity at the YNZ22 locus has been carried out by Southern blot or polymerase chain reaction (PCR).